Fostair and throat/voice irritation

[Particle32]

Hi all,

I recently had a severe asthma episode and was put on fostair 200/6 twice a day. My asthma now seems fine. However, my voice is weaker, and more hoarse than it was pre medication. I am throat clearing lots. This is accompanied by sticky mucus in the throat which is irritating my vocal cords. Is this a side effect of fostair? Or is it my asthma (or rhinitis). The impact on my voice is irritating as I use my voice in my job. I get sinusitis anyway so difficult to know where it is coming from.

Wondering about going to GP to reduce dose but don't want to do so soon after being bad and in hospital

[Particle32]

I mean 4 puffs a day

[Lysistrata Administrator Community Ambassador]

Are you rinsing your mouth out after you take it? I'm on the same dose and I need to gargle and rinse my mouth after it morning and evening, then spit out the water. If I don't. then I notice my voice gets hoarse. I'm fine if I rinse personally but I know others have more trouble.

I just use plain tap water, but some people use mouthwash. They should have told you this really as this is considered a high dose of inhaled steroid and it can cause oral thrush if not rinsed out.

I'd try the rinsing and see if that makes a difference. The sinusitis probably isn't helping though as the mucus from that can drip down and irritate your throat. Probably worth tackling that - another trip to the GP perhaps? It's worth sorting anyway for your job but also longer-term probably not good for your asthma as the mucus can drip down into your lungs.

This situation is also something the helpline can probably advise on - they gave me some great advice about using sterile saline to rinse out before I use my hayfever nasal spray, and how to use it. 0300 2225800 or WhatsApp [phone] Monday-Friday 0915-5pm

[Mons in reply to Lysistrata]

I’m on the same dose of Forstair. I rinse my mouth out with water and then gargle quickly with corsodyl after using the inhalers twice a day. This seems to help as i was getting a dry throat afterwards. If I need ventolin then I do the same.

[Shogi]

Great advice from Lysistrata, and hope that can help with your issue.

What I also find helpful, is using an “AeroChamber Plus” with the mask, rather than just the mouthpiece on it. If you’ve never been offered one, ask your GP/ Asthma Nurse about getting one, as each inhaled puff doesn’t just hit the back of your throat, and easier to take aerosol inhalers with this when your breathing is bad. I just use the AeroChamber at home, as it’s more hygienic than carrying it in your bag. You can buy these online too, but best to see GP or other to demonstrate how to use.

AeroChamber Plus, is a tube with face mask to make aerosol inhalers easier to use.

[Lysistrata Administrator Community Ambassador in reply to Shogi]

I hadn't thought of mentioning a spacer, as in my head it was the Fostair Nexthaler since that's what I use, so my first thought! But I've realised Particle32 didn't say which it is.

Good point though - if it is the spray/aerosol (MDI) version then using a spacer with any attachment would help as it gets more into the lungs and less into the mouth/throat. I hadn't thought of using the mask but that could be worth a try too.

[Shogi in reply to Lysistrata]

Forgot to question that. My consultant tried me on lots of different inhalers years ago, and I couldn’t use any of the dry powder versions, as they just stuck to my mouth and throat ( and never seemed to get into my lungs) in spite of rinsing and gargling, then drinking water after, and gave me terrible oral thrush, dry throat and I’d lose my voice for days on end. Can be a problem when you have to use any type of inhaler on a daily basis. Trial and error to find something that suits you best!

[peege]

Personally I rinse & gargle before as well as after using Fostair (100/6 MDI). Right or wrong I've a notion that whatever touches my throat is slightly diluted from the wetness. I don't like mouth wash, preferably to brush my teeth after the gargle and rinse. Powder inhalers I found to stick more to the oral soft tissues

[Particle32]

Thanks all. I am on the powder inhaler because they said that was better for voice. However, I could try the aerosol version. I'm also wondering if it's the asthma/rhinitis itself, as when clearing my throat, there is a bit of mucus there. I think I will see for a few weeks as still tapering off oral steroids and then speak to gp.

[strongmouse]

I know what you mean. I use an aerochamber and rinse and gargle every time I use my inhaler (also fostair) but at times it seems my throat has a lot of mucus and I sound hoarse. You could try using a nasal wash such as Neil Med before using the fostair. I have found that helps.

[Scrofulous]

Yes. I recently stopped Fostair because of the constant throat irritation, hoarseness and sometime sore throat. I take Luforbec instead which doesn't have that side effect, though I do have problems with the mechanics of the inhaler itself.